52553D - Rivenbark

CAMA / 'DREDGE & FILL r!
iENERAL PERMIT * Previous permit#
New Modification Complete Reissue _Partial Reissue Date previous permit issued
ized by the State of North Carolina,Department of Environment and Natural Resources:oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC I k. 156U
%Rules attached.
t Name 71 101 t ik-(Y1b1111l(✓ Project Location: County &Iw 1-17;u4ortvuo ,
{ 54o talt-i-u n y1t Street Address/State Road/Lot#(s) �j+ d 11 L
)11MA. 11 �o State NCr ZIP , l
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(alb) ��I-�I% Fax# ( ) Subdivision f i easy rc Cam
edAgent City C,aV0UNA aL ZIP Ut)
CW AEW PTA ❑ES - PTS Phone# ( ) ate River Basin Ca f-e
LI OEA IIIHHF CIIH ❑UBA —I N/A Adj.Wtr. Body Li.A Ait (nat
❑PWS: ❑FC:yes no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body ity I-L1 (CI AVC
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i l hill k(((k t(\ 'A&I1 V - MA k_ C (Scale: "A!/�
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distance offshore A#4I A''
x distance offshore - - ' � D 4 _
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ttached: yes no - -1- --._ i , I
ig permit may be required by: A 'f C/�j} J�, n tO. See note on back regarding River Basin ru
Special Conditions T/',Q Ull -4 rl i 1 J a . M O ll-!4{f i yct t 1 XECt VO hai ytC,l-

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101dcastle Precast® Inc. pip._ N.C. Prod
ox 27077 [phone] • Fax: [phone] 920 V
ih, NC 27611 www.ncpproducts.com Raleigh,
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to `•n
n (Name of Property Owner)
property located at 2 '7 ! e i,Al su..L�
(Lot,Block, Road,etc.)
on //e4s kc- e , in /tie. /,".AA &can ,N.C.
(Waterbody) (Town and/or County)
Applicant's phone#: 4/0-- SSID-gS 3'/Mailing Address: Z%/ 2 •
/'4.4Lw igeps•ci7 z6,4
He has described to me,as shown below,the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
4- 21/
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
21/ /�.�;i.41 ,a•L.,+z �!Z_ _ v-1,
Mailing Address ✓ Signature

•
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /i n-7 : 16:,ti k,4yzi ts
(Name of Property Owner)
property located at .1/ 3 l 4,;L S ta.a- �?
n (Lot,Block, Road, etc.)
on 7�'"/eAs. 3 --%% , in �.,,9•Q�/�it,4 c-%f1r�i ,N.C.
(Waterbbdy) (Town and/or County)
Applicant's phone#: 9/e-544-V S 5'I Mailing Address: 2/1 14/11,i&sr.t.L4
He has described to me, as shown below,the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
°Eyv,iv3 art
Mailing Address Signature

•
30292
RK CONSTRUCTION COMPANY
540 COLETON LANE,S.E.
BOLIVIA,NC 28422
PH.[phone] DATE 5-- 0 9 66-112-531
�Am i4' $ .OD Lac
` C ' ri
1 L DOLLARS
BMX ACCOUNTS PAYABLE
_ _ j)(�,j
s.cowP,u.,
_ NORTH CAROLINA v
_,J441.„04,
10030 2920 1:0 53 10 1 1 2 Li:000 5 2 1 7 6 3 9 5 2 4o